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Titolo:
Efficacy of oral anticoagulants compared with aspirin after infrainguinal bypass surgery (The Dutch Bypass Oral anticoagulants or Aspirin study): a randomised trial
Autore:
Tangelder, MJD; Algra, A; Lawson, JA; Eikelboom, BC; Tangelder, MJD; Algra, A; Tijssen, JGP; Briet, E; Hamming, JJ; Algra, A; Banga, JD; Eikelboom, BC; van Gijn, J; Hauer, RNW; de Jaegere, PPT; Kappelle, LJ; Lawson, JA; Rinkel, GJE; Tangelder, MJD; Weaver, EFD; van Aken, PJ; Algra, A; van Bockel, JH; Buth, J; van den Dungen, JJAM; Eikelboom, BC; Lawson, JA; Moll, FL; Rauwerda, JA; de Smit, P; Tangelder, MJD; van Urk, H; de Vries-Goldschmeding, J; Sixma, JJ; Tangelder, MJD; van Gelder, EAM; van Leeuwerden, M; van Nimwegen, MWM; van Ossanen-Holierhoek, YCW; Poerschke, MA;
Indirizzi:
Dept Vasc Surg, BOA Trial Off, NL-3508 GA Utrecht, Netherlands Dept Vasc Surg Utrecht Netherlands NL-3508 GA 08 GA Utrecht, Netherlands
Titolo Testata:
LANCET
fascicolo: 9201, volume: 355, anno: 2000,
pagine: 346 - 351
SICI:
0140-6736(20000129)355:9201<346:EOOACW>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
PERIPHERAL ARTERIAL-DISEASE; INTERMITTENT CLAUDICATION; GRAFTS; DIPYRIDAMOLE; MORTALITY; PATENCY; ISCHEMIA;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
21
Recensione:
Indirizzi per estratti:
Indirizzo: Eikelboom, BC Dept Vasc Surg, BOA Trial Off, POB 85500, NL-3508 GA Utrecht, Netherlands Dept Vasc Surg POB 85500 Utrecht Netherlands NL-3508 GA nds
Citazione:
M.J.D. Tangelder et al., "Efficacy of oral anticoagulants compared with aspirin after infrainguinal bypass surgery (The Dutch Bypass Oral anticoagulants or Aspirin study): a randomised trial", LANCET, 355(9201), 2000, pp. 346-351

Abstract

Background Oral anticoagulants and aspirin are antithrombotic drugs that are commonly used in patients with vascular disease. We investigated whethereither of these treatments prevented more effectively than the other bypass complications after infrainguinal bypass surgery. Methods We did a multicentre, randomised, open trial. 2690 patients who had undergone infrainguinal grafting were randomly assigned oral anticoagulants (target international normalised ratio 3.0-4.5, n=1339) or aspirin (80 mg daily, n=1351). We followed up patients for a mean of 21 months. The primary outcome was graft occlusion. Findings 308 graft occlusions occurred in the oral-anticoagulants group compared with 322 in the aspirin group (hazard ratio 0.95 [95% Cl 0.82-1.11]), which suggested no overall advantage for either treatment. Oral anticoagulants were beneficial in patients with vein grafts (0.69 [0.54-0.88]), whereas aspirin had better results for non-venous grafts (1.26 [1.03-1.55]). The composite outcome of vascular death, myocardial infarction, stroke, or amputation occurred 248 times in the oral-anticoagulants group and 275 times in the aspirin group (0.89 [0.75-1.06]). Patients treated with oral anticoagulants had more major bleeding episodes than those treated with aspirin (108 vs 56; 1.96 [1.42-2.71]). Interpretation Oral anticoagulation was better for prevention of infrainguinal-vein-graft occlusion and tor lowering the rate of ischaemic events. Aspirin was better for the prevention of non-venous graft occlusion, and was associated with fewer bleeding episodes.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 10/07/20 alle ore 14:43:59